Thymectomy is more effective than conservative treatment for myasthenia gravis regarding outcome and clinical improvement

Surgery. 2009 Apr;145(4):392-8. doi: 10.1016/j.surg.2008.11.009. Epub 2009 Feb 8.


Background: Myasthenia gravis (MG) is an autoimmune disease with a tremendous impact on the quality of life. Controversies over which patients should be operated on because they may benefit most from thymectomy are still ongoing. The aim of this study was to report our long-term results of patients with MG with comparison of thymectomy and conservative treatment.

Methods: We report a series of 252 patients with MG. Survival data were generated. Patients were seen in the outpatient clinic, where a modified Osserman score and quality of life score were evaluated at the end of the follow-up period for all surviving patients.

Results: A total of 172 patients with MG were followed after thymectomy or with conservative treatment for a median time of 9.8 years. Patients who underwent thymectomy had significantly greater rates of remission and improvement compared with conservative treatment. Furthermore, they had a significantly greater survival.

Conclusion: Currently, different effective modalities of treatment are available in patients with MG. In our long-term follow-up, thymectomy was superior to conservative treatment regarding overall survival, clinical improvement, and remission rate. Therefore, thymectomy should be considered strongly for all patients with generalized MG.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Female
  • Germany / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Myasthenia Gravis / diagnosis
  • Myasthenia Gravis / mortality
  • Myasthenia Gravis / surgery*
  • Quality of Life*
  • Thymectomy*
  • Treatment Outcome
  • Young Adult